The golden rule: A cornerstone in the ethical care of patients

Oct 01, 2005

How would you define the term "profession?" How does it differ from other occupations?

A profession has been defined as an occupation that 1) regulates itself through systematic required education or collegial discipline; 2) has a base in technical, specialized knowledge, and 3) has a service, rather than a profit orientation, enshrined in an ethical code.

How would you define the term "ethic?" The word ethic is derived from the Greek word "ethos", meaning character or custom. It implies conforming to moral standards, or conforming to the standards of conduct of a given profession. To be ethical, one must be in accord with some moral standard or code of conduct. The term moral is derived from the Latin word "moralis", which signifies manners. Morality deals with or makes a distinction between right or wrong conduct. It implies conforming to a standard of right behavior. Synonyms for moral include the term's virtue and ethic. Law is not a synonym for morality.

DVM Newsbreak
The original United States Veterinary Medical Association Code of Ethics was adopted in 1867. Now, broad-based and general principles of veterinary medical ethics have been adopted by the American Veterinary Medical Association. They encompass such topics as guidelines for professional behavior, advertising, fees, referrals, consultations, relationship with clients and various other aspects of the practice of veterinary medicine. Ethical principles governing the practice of veterinary medicine are often more stringent than legal controls. However, they do not cover all facets of veterinary medicine. The ultimate test of our ethics is the conduct they dictate or inspire. The ultimate challenge of our behavior is to choose the best course of conduct or action when existing rules and guidelines do not apply.

The American Veterinary Medical Association made the following statement about the "Principles of Veterinary Medical Ethics" (note the emphasis on the golden rule): "Exemplary professional conduct upholds the dignity of the veterinary profession. All veterinarians are expected to adhere to a progressive code of ethical conduct known as the Principles of Veterinary Medical Ethics. The basis of the principles is the golden rule. Veterinarians should accept this rule as a guide to their general conduct and abide by the principles. They should conduct their professional and personal affairs in an ethical manner."

The principle

Can you recite the golden rule from memory? Recall that the golden rule is a rule of ethical conduct from Matthew 7:12 and Luke 6:31, stating that we should do for others as we would have others do for us. A version of this principle is attributed to the Chinese philosopher Confucius (551-479 BC). He said, "What you do not want done to yourself, do not do to others." Compared with the Biblical version, this version is negative (do not do to others) rather than positive (do to others).

Practicing the positive version of the golden rule means that we must take the initiative in being altruistic (having unselfish concern for the welfare of others). Altruism (the opposite of egoism) demands that we consider the interest of others when we use our talents and possessions. Thus, the golden rule is of little value unless we recognize that the first move is ours. To practice the golden rule, we must strive to put ourselves in others' shoes, paws, hooves or claws. In keeping with this principle, I propose five applied rules to enhance the ethical care of patients. (This essay was adapted from a commentary published in JAVMA 217:1622 – 1624, 2000.)

Rule 1

Learn about the diseases of our patients as we want physicians to learn about us.

Consider the following corollaries of Rule No. 1.

  • Corollary 1: